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FORM 5500 DATA

Athena Health Care Associates, Inc. 401k Plan

Overview

Plan Information

  • Plan Year10/01/2016 — 09/30/2017
  • Date of Plan01/01/1987
  • Net Assets as of 09/30/2017 $68,670,675
  • Plan Number334
  • Plan Type Single Employer
  • Is the plan collectively bargained? No
  • Did the plan file for an extension of time or the DFVC Program?Yes
  • Plan Funding ArrangementInsurance Trust
  • Plan Benefit ArrangementInsurance Trust

Participant Information as of 09/30/2017

  • Active (Eligible) Participants8,178
  • Retired or separated participants receiving benefits16
  • Other retired or separated participants entitled to future benefits999
  • Subtotal9,193
  • Deceased participants whose beneficiaries are receiving or are entitled to receive benefits5
  • Total9,198
  • Total number of participants as of 10/01/20168,993
  • Number of participants with account balances3,453
  • Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested85

Expenses

  • Total Benefit Payments$0
  • Corrective Distributions$0
  • Administrative Service Providers$0
  • Other Expenses$0
  • Total Expenses$0
  • Total Transfers$0

Sponsor Information

  • Address135 South Road
  • CityFarmington
  • StateCT
  • Zip06032
  • Telephone(860) 751-3900
  • EIN06-1116677
  • Industry Code623000

Audit Information

  • Audit StatusAudited
  • AuditorDworken, Hillman, Lamorte & Stercza
  • Auditor EIN06-1308345
  • Audit Opinion Disclaimer
  • Audit TypeLimited Scope Audit

Benefits Provided Under the Plan

Code Benefit Description
2E Profit-sharing A defined contribution plan that allows employer discretionary contributions. These plans often contain a 401(k) feature.
2F ERISA section 404(c) Plan This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
2G Total participant-directed account plan Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
2J Code section 401(k) feature A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
2T Participant-directed Account Total or partial participant-directed account plan - plan uses default investment account for participants who fail to direct assets in their account.
3D Master plan A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.
3H Controlled Group Plan sponsor(s) is (are) a member(s) of a controlled group (Code sections 414(b), (c), or (m)).

Questions and Answers

Question Answer Amount
During the plan year did the employer fail to transmit to the plan any participant contributions within the time period described in 29 CFT 2510.3-102? No
Were any loans by the plan or fixed income obligations due the plan in default as of the close of plan year or classified during the year as uncollectible? Disregard participant loans secured by participant's account balance. No
Were any leases to which the plan was a party in default or classified during the year as uncollectible? No
Were there any nonexempt transactions with any party-in-interest? No
Was this plan covered by a fidelity bond? Yes $500,000
Did the plan have a loss, whether or not reimbursed by the plan's fidelity bond, that was caused by fraud or dishonesty? No
Did the plan hold any assets whose current value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan receive any noncash contributions whose value was neither readily determinable on an established market nor set by an independent third party appraiser? No
Did the plan have assets held for investment? Yes
Were any plan transactions or series of transactions in excess of 5% of the current value of plan assets? No
Were all the plan assets either distributed to participants or beneficiaries, transferred to another plan, or brought under the control of the PBGC? No
Has the plan failed to provide any benefit when due under the plan? No
If this is an individual account plan, was there a blackout period? No
If there was a blackout period, have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? No

Financials

Income and Expense Statement

Income $13,841,854
Contributions $7,544,105
Cash Contributions $7,544,105
Cash from Employers $1,063,200
Cash from Participants $5,845,111
Others (including rollovers) $635,794
Noncash Contributions $0
Total Earnings on Investments $6,245,889
Total Interest $373,020
Interest-Bearing Cash $299,449
U.S. Government Securities $0
Corporate Debt Instruments $0
Loans (other than to participants) $0
Participant Loans $73,571
Interest from Other Investments $0
Total Dividends $1,927,767
Preferred Stock $0
Common Stock $0
Rents $0
Net gain (loss) on sale of assets $0
Aggregate Proceeds $0
Aggregate Carrying Amount $0
Total Unrealized Appreciation (depreciation) of assets $0
Real Estate $0
Other $0
Net investment gain (loss) from common/collective trusts $0
Net investment gain (loss) from pooled separate accounts $0
Net investment gain (loss) from master trust investment accounts $0
Net investment gain (loss) from 103-12 investment entities $0
Net investment gain (loss) from registered investment companies $3,945,102
Other Income $51,860
Expenses $5,560,502
Total Benefit Payments $5,003,053
Directly to participants or beneficiaries, including direct rollovers $5,003,053
To insurance carriers for the provision of benefits $0
Other Benefit Payment Fees $0
Corrective Distributions $59,619
Certain deemed distributions of participant loans $163,549
Interest expense $0
Total Administrative Expenses $334,281
Professional Fees $0
Contract Administrator Fees $288,136
Investment Advisory and management fees $0
Other Administrative Fees $46,145
Net Income $8,281,352
Transfers of Assets to this Plan $0
Transfers of Assets from this Plan $0

Asset and Liability Statement

09/30/2017 09/30/2016 Change YOY
Total Assets $68,670,675 $60,389,323 13.71%
Total noninterest-bearing cash $0 $0 0.0%
Receivables $258,317 $125,704 105.50%
Employer Contributions $40,710 $19,192 112.12%
Participant Contributions $217,607 $106,512 104.30%
Other Contributions $0 $0 0.0%
General Investments $0 $0 0.0%
Interest-bearing cash $0 $0 0.0%
U.S. Government Securities $0 $0 0.0%
Corporate Debt Instruments $0 $0 0.0%
Preferred $0 $0 0.0%
All Other $0 $0 0.0%
Corporate Stocks $0 $0 0.0%
Preferred $0 $0 0.0%
Common $0 $0 0.0%
Partnership/joint venture interests $0 $0 0.0%
Real estate (other than employer real property) $0 $0 0.0%
Loans (other than to participants) $0 $0 0.0%
Participants Loans $1,837,824 $1,754,180 4.77%
Value of interest in common/collective trusts $0 $0 0.0%
Value of interest in pooled separate accounts $0 $0 0.0%
Value of interest in master trust investment accounts $0 $0 0.0%
Value of interest in 103-12 investment entities $0 $0 0.0%
Value of interest in registered investment companies $54,811,076 $47,694,923 14.92%
Value of funds held in insurance co. general account $0 $0 0.0%
Other Investments $11,763,458 $10,814,516 8.77%
Employer-related Investments $0 $0 0.0%
Employer Securities $0 $0 0.0%
Employer Real Property $0 $0 0.0%
Buildings and other property used in plan operation $0 $0 0.0%
Total Liabilities $0 $0 0.0%
Benefit Claims Payable (1) $0 $0 0.0%
Operating Payables (1) $0 $0 0.0%
Acquisition Indebtedness (1) $0 $0 0.0%
Other liabilities (1) $0 $0 0.0%
Net Assets $68,670,675 $60,389,323 13.71%

Service Providers

Persons Receiving Only Eligible Indirect Compensation

There is no information on eligible indirect compensation for this plan.

Other Service Providers Receiving Direct or Indirect Compensation

Name Nature of Service Relationship to Plan Sponsor Direct Compensation Paid by Plan Indirect Compensation Paid by Plan Total Compensation
Lincoln National Corporation Contract Administrator Service Provider $288,136 $0 $288,136
Acg Associates, Inc. Accounting (including auditing) Consultant $29,145 $0 $29,145
Dworken, Hillman, Lamorte & Stercza Accounting (including auditing) Consultant $17,000 $0 $17,000
Total $334,281 $0 $334,281

Indirect Compensation

There are no service providers with indirect compensation listed for this plan.

Service Providers Who Fail or Refuse to Provide Information

There are no service providers who failed or refused to provide information.

Termination Information on Accountants and Enrolled Actuaries

There is no termination information for this plan.

Investments

Investments

No investments information available for this plan.

Insurance Information

Insurance Information

Insurance Carrier Summary Persons Covered
Lincoln National Life Company 9,198
EIN 35-0472300
Industry Code 65676
Contract Number 892807-087
Contract Year 10/01/2016 — 09/30/2017
Value in General Account at Year End $11,763,458
Value in Separate Accounts at Year End $54,811,076
Insurance Fees and Commissions $32,891
Persons Receiving Commissions and Fees
Agent/Broker Organization Code Commissions Paid Fees Paid Purpose of Fees Paid
Lpl Financial 5935 Cornerstone Ct San Diego, CA 92121 Investment Manager/Adviser $32,891 $0 N/A
Allocated Funds
Type of Contract Unspecified
Basis of premium rates
Premiums paid to carrier $0
Premiums due but unpaid at the end of the year $0
If the carrier, service, or other organization incurred any specific costs in connection with the acquisition or retention of the contract or policy, enter amount $0
Specify the nature of the costs
Unallocated Funds
Type of Contract GIC
Balance at the end of the previous year $10,814,516
Additions $1,694,600
Contributions Deposited during the year $1,215,890
Dividends and credits $98
Interest credited during the year $194,106
Transferred from separate account $0
Other $284,506
Total of Balance and Additions $12,509,116
Deductions $1,299,719
Disbursed from fund to pay benefits or purchase annuities during the year $941,310
Administration charge made by carrier $52,426
Transferred to Separate Account $0
Other $305,983
Balance at the end of the current year $11,209,397